[The assessment of the sanitation of surfaces and instruments in the context of hospital refection]. / Idoneità igienico-sanitaria delle superfici e degli strumenti nella ristorazione collettiva: analisi di un'esperienza nella realtà ospedaliera.

The Authors present the results of an experience carried out in a University General Hospital, for the assessment of the sanitation of surfaces and instruments in the context of hospital refection. A specific procedure has been quarterly implemented in order to verify the correct execution of the sanitization procedures. In the time-period September 2016 - March 2020 Petri dishes and tampons were used in order to determine the following microbiological parameters and indicators: total bacterial load at 30 degrees C, Coliforms, Listeria monocytogenes, Salmonella spp, Staphylococcus aureus, Escherichia coli and mycetic load. Only 7 out of 82 sanitized surfaces (8.5% of the total) were found to be not complying, only for total bacterial load at 30 degrees C, mycetic load and Coliforms. The systematic application of this procedure and the results of the survey conducted, comforting as a whole, confirm the attention reserved to the hygienic level of surfaces, tools, equipment and utensils, in the context of the centralized catering service of the hospital, in which the Health Department, sharing with the UOC Hospital Hygiene the specific hygienic procedure, has always been at the forefront of the proposal of interventions, considering the increased susceptibility and vulnerability of the hospitalized patients.

[Hospital foodservice through the Cook Chill system: a two-year experience in a University teaching hospital, Italy]. / La ristorazione in ospedale mediante il sistema "Cook and Chill": un'esperienza di 2 anni in un Policlinico Universitario.

The Authors present their two-year experience regarding an evaluation of the hygienic quality of ready-to-eat foods in a hospital foodservice, both for patients' meals and hospital staff, prepared by using the Cook Chill system. According to the microbiological parameters provided by International Guidelines, 23 of 27 food samples that were collected and analyzed were found to be satisfactory, one was acceptable and only three were unsatisfactory (two for aerobic colony count and one both for aerobic colony count and hygienic procedure). Escherchia coli, Staphylococcus aureus, Salmonella, Listeria monocytogenes, and Clostridium perfringens were absent in all of the analyzed products, The study results are encouraging and confirm the need to always verify that the different phases of production of hospital meals are correctly implemented, even when the foodservice is out-sourced. This has always been considered a priority in the study hospital, where the Health Department is at the forefront both in control and verification of food safety practices and in offering training activities, especially in view of the increased susceptibility of hospitalized patients.

[Hygienic safety of infant milk powder formulas in hospital setting]. / La sicurezza igienica del latte in polvere per la prima infanzia nella realtà ospedaliera.

The authors present the results of a study whose aim was to assess the hygienic quality of powder and reconstituted milk for early childhood, in a University General Hospital in Rome, Italy. This procedure is an integral part of the systematic verification activities that the hospital Health Management department considers as a priority for patient safety. The absence of contamination in all tested samples confirms the suitability of adopted procedures to ensure a safe product, considering the increased vulnerability of newborns, especially if preterm.

[Hygienic suitability of food and food-contact surfaces in a hospital canteen: the experience of a University Hospital in Italy]. / Idoneità igienico-sanitaria di alimenti e superfici in una mensa ospedaliera: un'esperienza in un Policlinico Universitario.

The Authors present the results of a study performed during a time-period of two years, to evaluate the hygienic quality of ready-to-eat foods, prepared and served in a hospital catering service, and the microbiological status of food-contact surfaces. Food hygiene was evaluated using non-pathogenic indicator microorganisms. The study was part of the verification activities that the hospital Health Department considers as a priority in order to guarantee patient safety. Only one of 52 food samples tested was considered unsatisfactory; the examined surfaces were not fully satisfactory in one of four cases. The study results, although encouraging as a whole, especially with respect to the hygienic safety of food prepared and served in the hospital, confirm the need to continuously verify that the appropriate environmental sanitation procedures are applied, even in the case of outsourcing. Considering the increased susceptibility of hospitalized patients, this remains a priority in the hospital where the study was performed.

Is reprocessing after disuse a safety procedure for bronchoscopy?: A cross-sectional study in a teaching hospital in Rome.

A bacteriological assessment of flexible bronchoscopes that were stored after a reprocessing procedure was performed to determine whether reprocessing removes microbiological contamination and whether the instruments could be used safely after extended storage without repeating the disinfection before bronchoscopy. The microbiological quality of manual and automated reprocessed bronchoscopes was examined by collecting a pre-reprocessing and a post-reprocessing liquid sample from the stored instruments' channels. A qualitative microbiological analysis was performed to evaluate bacterial contamination. Among the 264 pre-reprocessing bronchoscopes, 10 were contaminated (13 human flora strains and 1 environmental strain were detected). After reprocessing, 8 were decontaminated and 2 remained contaminated. Furthermore, 12 other bronchoscopes had a new contamination post-reprocessing (11 human flora and 3 environmental strains were detected). In addition, 2 sampled bronchoscopes were contaminated both pre- and posttreatment. Our findings support the suggestion that reprocessing after storage can be avoided in the safe usage of the instrument if earlier decontaminations are performed correctly. Having found that reprocessing could contaminate bronchoscopes, additional studies are needed to identify the risk factors for contamination and avoid controversial suggestions for first-use reprocessing.

Legionella on board trains: effectiveness of environmental surveillance and decontamination.

BACKGROUND: Legionella pneumophila is increasingly recognised as a significant cause of sporadic and epidemic community-acquired and nosocomial pneumonia. Many studies describe the frequency and severity of Legionella spp. contamination in spa pools, natural pools, hotels and ships, but there is no study analysing the environmental monitoring of Legionella on board trains. The aims of the present study were to conduct periodic and precise environmental surveillance of Legionella spp. in water systems and water tanks that supply the toilet systems on trains, to assess the degree of contamination of such structures and to determine the effectiveness of decontamination. METHODS: A comparative pre-post ecological study was conducted from September 2006 to January 2011. A total of 1,245 water samples were collected from plumbing and toilet water tanks on passenger trains. The prevalence proportion of all positive samples was calculated. The unpaired t-test was performed to evaluate statistically significant differences between the mean load values before and after the decontamination procedures; statistical significance was set at p ≤ 0.05. RESULTS: In the pre-decontamination period, 58% of the water samples were positive for Legionella. Only Legionella pneumophila was identified: 55.84% were serogroup 1, 19.03% were serogroups 2-14 and 25.13% contained both serogroups. The mean bacterial load value was 2.14 × 10(3) CFU/L. During the post-decontamination period, 42.75% of water samples were positive for Legionella spp.; 98.76% were positive for Legionella pneumophila: 74.06% contained serogroup 1, 16.32% contained serogroups 2-14 and 9.62% contained both. The mean bacterial load in the post-decontamination period was 1.72 × 10(3) CFU/L. According to the t-test, there was a statistically significant decrease in total bacterial load until approximately one and a half year after beginning the decontamination programme (p = 0.0097). CONCLUSIONS: This study indicates that systematic environmental surveillance could be a useful approach for assessing the risk of exposure to Legionella bacteria, which still represents a public health threat. According to the study results, an environmental surveillance programme, followed by decontamination procedures where necessary, would decrease the total bacterial count, protecting the health of travellers and workers.